The Difference Between Normal Cognitive Aging and Dementia

Dr. Amanda Wiggins
Xtendlife Research Scientist

Dr. Amanda Wiggins works with Xtendlife as the Chief Research Scientist, where she shares her knowledge of research, science, and wellness.

Mental decline is one of the most feared consequences of aging, and for good reason. It is incredibly hard to watch a loved one go through dementia. In addition to wishing for a cure, you may be reflecting on your own memory and wondering whether you're headed for the same fate.

In this Health Article, we'll look at the three broad types of mental decline that occur through old age. Firstly, we'll outline what's considered normal in terms of cognitive aging. Secondly, we will discuss the signs and symptoms of mild cognitive impairment, a condition that puts you at greater risk of developing dementia. And thirdly, we'll outline the 10 signs of Alzheimer's disease, including early warning signs.

Normal Cognitive Aging

It's perfectly normal to forget things occasionally or for thinking to be less clear as we age. The exact age where this becomes noticeable varies from person to person. For some people, the feeling of being less mentally sharp may be noticeable in their mid-forties, for others, it may not be until they are well into their sixties.

It’s perfectly normal to forget things occasionally.

Examples of normal cognitive aging include forgetting small details or sometimes taking longer to remember a word. With normal cognitive aging, the changes will not be noticeable to friends or family.

Signs that are considered a normal part of aging are:

Being slower to find words and names
Forgetting parts of an experience
Forgetting where you parked the car
Forgetting people or events from the distant past
Experiencing a mild decrease in attention span, having to focus harder on tasks

Although cognitive speed, focus, and memory are reduced in older age, there is growing evidence that the brain maintains the ability to change and adapt. The key is to keep learning and trying new things.

The saying “use it or lose it” is absolutely true for brain power in older age.

Make a plan to try new things, ideally with a buddy or group. Social interaction is very important for brain health as we age. For more details, take a look at some of our blogs:

Mild Cognitive Impairment

Mild cognitive impairment (MCI) is a distinct neurological condition that is not just normal aging. MCI causes cognitive changes that are serious enough to be noticed by the person affected and by family and friends, but it doesn't affect the individual's ability to carry out their daily activities.

A lot of research has gone into understanding MCI over the years because it is considered a major risk factor for developing dementia. Between 10 - 15% of those with MCI go on to develop dementia every year. About a third of people with MCI develop Alzheimer's disease within five years.

As with most neurological conditions, MCI does not have a single cause. There is no single test that can give a definitive diagnosis of MCI and no specific treatment. Once someone is diagnosed with MCI, the outcome can vary depending on the underlying cause and other factors. While those with MCI are considered at increased risk of developing dementia, some people with MCI revert to normal cognition or never experience additional cognitive decline.

Signs that may be indicative of MCI are:

Forgetting conversations
Frequently misplacing items in the home
Difficulty keeping the train of thought during a conversation
Increasing difficulty finding the right word or having more difficulty finding words compared to people of the same age
Difficulty finding your way around a once-familiar place
Difficulty executing everyday tasks such as paying a bill

If you are concerned about your memory or thinking, it's best to discuss it with your health professional.

Dementia

Dementia is not a specific disease, but rather it is an umbrella term used to describe impaired ability to remember, think, or make decisions that interfere with everyday activities.

Alzheimer's disease is the most common type of dementia. Alzheimer's disease accounts for about two-thirds of dementia cases. The next most common form of dementia is vascular dementia. There are dozens of types of dementia, and a person may have 'mixed dementia' meaning they have signs of more than one type of dementia.

Researchers believe that Alzheimer’s begins 20 years or more before the onset of symptoms.

Dementia is a progressive disease that starts with mild symptoms and for most people, the changes gradually spread through the brain and lead to the symptoms getting worse. Researchers believe that Alzheimer's begins 20 years or more before the onset of symptoms. The extended time frame for developing dementia helps explain why it has been difficult to prevent and treat Alzheimer's disease effectively.

Because the term dementia is a general term, symptoms are different depending on the type of dementia, and symptoms can vary widely from person to person.

The Warning Signs for Alzheimer’s

If we look at Alzheimer's disease specifically, there are 10 warning signs to be aware of:

Memory loss that disrupts daily life. One of the most common signs of Alzheimer's disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids or family members for things they used to handle on their own.
Challenges in planning or solving problems. For example, some people with dementia may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
Difficulty completing familiar tasks. People with Alzheimer's often have trouble driving to a familiar location, organizing a grocery list, or remembering the rules of a favorite game.
Confusion with time or place. People living with Alzheimer's can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
Trouble understanding visual images and spatial relationships. For example, some people may have difficulty with balance or trouble reading or may have problems judging distance and determining color or contrast, causing issues with driving.
New problems with words in speaking or writing. People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may have trouble naming a familiar object or use the wrong name (e.g., calling a "watch" a "hand-clock").
Misplacing things and losing the ability to retrace steps. A person with Alzheimer's disease may put things in unusual places. They may lose things and may accuse others of stealing, especially as the disease progresses.
Decreased or poor judgment. For example, some people may use poor judgment when dealing with money or pay less attention to personal hygiene.
Withdrawal from work or social activities. Due to changes in the ability to hold or follow a conversation, some people with Alzheimer's withdraw from hobbies, social activities or other engagements.
Changes in mood and personality. Individuals with Alzheimer's may become confused, suspicious, depressed, fearful, or anxious. They may be easily upset at home, with friends, or when out of their comfort zone.